Chronic fatigue syndrome

Besides a debilitating fatigue unrestored by rest, common symptoms of CFS include:

• More intense or changed patterns of headaches
• Reduced short-term memory or concentration
• Recurrent sore throats
• Tender lymph nodes
• Muscle discomfort or pain
• Joint pain without joint swelling or redness
• Unrefreshing sleep

The severity of CFS symptoms varies broadly among individuals. Some patients report mild to moderate symptoms of anxiety or depression. However, it is important to note that 60 per cent of carefully evaluated CFS patients do not have depression or another psychiatric illness.

How is it diagnosed?
CFS is often misdiagnosed because its symptoms are shared by other disorders, including glandular fever, fibromyalgia, Lyme disease, post-polio syndrome and autoimmune diseases such as lupus and multiple sclerosis. There also are no specific tests for CFS that a doctor can use to diagnose the illness.

The UK National Institute for Health and Clinical Excellence (NICE) guidelines suggest that a doctor should consider the diagnosis of chronic fatigue syndrome if fatigue has been present for 4 months in an adult, or 3 months in a child (and other possible diagnoses have been excluded) where:

• New, persistent and/or recurrent, not explained by other conditions and has resulted in a substantial reduction in activity level with post-exertional malaise and/or fatigue which is typically delayed and one or more of the following are present:


• difficulty sleeping
• muscle and/or joint pain at multiple sites without evidence of inflammation
• headaches
• painful lymph nodes that are not enlarged
• sore throat
• difficulty thinking or concentrating
• worsening of symptoms by physical or mental exertion
• general malaise or flu-like symptoms
• dizziness and/or nausea
• palpitations with no obvious heart problem